[What are the risk factors specific to patient for debonding of orthodontic brackets?]

Abstract

The premature detachment of orthodontic brackets has consequences for the patient and the practitioner. While the responsibility for the bonding protocol has been widely assessed, the responsibility of the patient is poorly understood. The main objective of the study was to look for patient-specific predictors of metal vestibular attachment detachments. An historical cohort study was carried out from adolescents having benefited from a fixed vestibular appliance treatment lasting 27 months +/- 3 months, having all teeth from first molar to first molar on arch to pose. Univariate and multivariate analyses were performed by logistic regression. 333 patients were included. In univariate analysis, boys tended to take off more than girls, patients in skeletal Class II more than those in Class I, those with at least two cooperative remarks more than those with less than two remarks. The percentage of patients with debonding increases with the number of hygiene remarks. Younger patients were more prone to debond than older patients. The "age" factor has a significant effect in multivariate analysis. Neither the vertical skeletal pattern nor the socio-economic level would intervene in the rate of debonding. The role of patient-specific factors in detachment should be put into perspective. The reliability of the results would be increased by a prospective study using validated indicators of compliance.